


Maybe Now, Maybe Never

by allgoodlions



Category: Carmilla (Web Series)
Genre: F/F
Language: English
Status: In-Progress
Published: 2016-07-09
Updated: 2016-07-09
Packaged: 2018-07-22 11:19:23
Rating: Mature
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 1,795
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/7435312
Author URL: https://archiveofourown.org/users/allgoodlions/pseuds/allgoodlions
Summary: <blockquote class="userstuff">
              <p>Setting bones, throwing stitches -- that’s Carmilla’s every day. As an emergency medicine resident, she doesn't have time for doubt or second thoughts. She's all cynicism and hard angles, and she prefers it that way. </p><p>Maybe a patient comes along who changes everything. Maybe she changes nothing at all.</p>
            </blockquote>





	Maybe Now, Maybe Never

**Author's Note:**

> I started writing a Carmilla hospital au that nobody asked for right in the middle of my internal medicine rotation. I did this to myself.

_It is ugly and it is black, and it eats up the sky. It’s in her nose and the back of her throat, and each breath sears her lungs and stings her eyes and someone is screaming, screaming, a flat, gnawing note that--_

\-- drags Carmilla into wakefulness. She jerks up, cheek detaching from the mattress beneath her face with a wet _smack_ that stings. That reminds her of -- something… But it’s gone the moment she reaches for it, dissolving back into her subconscious before it even finds form.

She’s still groggy, still mostly horizontal, hanging half on, half off a spare gurney parked near a supply closet in one of the hospital’s back hallways. With a grunt, she levers herself up and fishes her phone out of her back pocket just as a headache balloons into being inside her skull. She squints blearily at the overbright display, heartily resenting the little spears of light that seem to core directly into her overfull brain. It’s a little past three on a Saturday morning. _So forty.. forty-five minutes._ She’s gotten forty-five minutes of sleep before -- hell, why is she actually --

“Trauma yellow, emergency department. Trauma yellow, emergency department.” The cool voice from the overhead speakers is like being doused in icy water. Always is. Carmilla’s headache takes an abrupt back seat to the sudden thrill of adrenaline that has her up and moving like a hectic automaton.

Springing off the gurney -- narrowly dodging a nurse who bustles out of the supply closet with an armful of abdominal pads -- she whisks down the hall, scrubbing drool from her cheek and gathering her hair into a hasty bun.

There’s the _whoop whoop whooo-oop_ of sirens in the distance, and her stomach scoops in anticipation.

As if on cue, the pager clipped to her scrubs buzzes against her hipbone and trills, all tinny and high like leveling up in an old arcade game. She grabs it up to read its small, dull screen: TRAUMA YELLOW and a callback number.

Thumbing the number into her work phone -- one of those solid, no-frills types you can throw off a building and not even leave a scratch -- she gets an answer on the first ring:

“Emergency department, this is Sarah Jane,”

“SJ, it’s Carmilla. I’m on tonight. You guys paged?”

“Trauma inbound. Three, maybe four minutes? House fire.”

“Fire?” Some small part of Carmilla’s mind starts reeling off a list of possible injuries. “Anything else? How many coming in?”

“Should be three, all burns, vital signs stable. Sorry, that’s all I got from the rigs.”

“I'll be right there,” Carmilla promises, and punches END.

The trauma tone sounds again, dull and piercing. A pregnant silence and then, “Trauma yellow times three, emergency department. Trauma yellow times three, emergency department.”

It’s been a hell of a night-- busy and endless in a way that makes it hard for Carmilla to remember to lift her feet off the ground when she walks. Means she stumbles a lot, but she never breaks stride. She prefers busy nights.

Busy nights as an emergency medicine resident mean running around putting out fires (Carmilla grins wryly. It’s not the pun so much as the cynicism -- she’s got it in spades, and she’s not very sorry). There’s never a spare moment for doubt or second thoughts in e-med. It’s all instinct and a sort of fly-by-the-seat-of-your-pants attitude that suits Carmilla. _Don’t_ _think,_ one of her attendings once advised her. She likes that.

Friday and Saturday nights, especially _late_ nights, are primetime weirdness central. Sure, there are the ubiquitous lacs and fist fights. Maybe a drunk or two needing a banana bag. Setting bones, throwing stitches -- that’s Carmilla’s every day. But the weekend is reserved for special types of stupidity. Unlikely objects in even more unlikely places (“I just _fell_ on it, I swear.”). Designer drugs and bad trips. Criminals cuffed to their gurneys and spitting at the nurses. Drunk college students leaping off buildings on a dare.

With the weird comes the bad, too. Carmilla has seen plenty of drug overdoses, gunshot wounds, sometimes cases of elder abuse or child abuse. Car accidents. Her brain automatically pulls away from that one, the way a cat kinda contorts its spine when it doesn’t want to be touched. But that’s the job. Residents tended to harden up pretty quickly. It’s either that or wash out.

Carmilla pushes through the emergency department’s double doors to find the usual controlled chaos. Most every bed is occupied and EMS gurneys line the walls. Friends and family mill about, blocking the hospital employees as they try to go about their work. Monitors beep discordantly. Somewhere, a kid cries. She catches snatches of conversation in the general din.

" -- swear I just sat on it -- "

" -- gonna be okay, baby --"

" -- broken. Page orthopedics."

Carmilla wades through the fray and bellies up to the nurse’s station where SJ sits with a phone cradled between shoulder and ear. She smiles tightly in greeting, holds up three fingers, and jerks her chin in the direct of trauma bay three. Carmilla mouths her thanks and it’s into the mess once more.

Trauma bay three is crowded with nurses, techs, doctors, and even a couple of third year medical students in blindingly teal scrubs, all jockeying for position in cramped quarters. Carmilla pulls a lead apron and vest from a bank of hooks on the wall, and secures the Velcro snugly at her hips. Over that goes a disposable gown, gloves, and a face shield.

All kitted up, she immediately starts to sweat. It’s a hot summer night and the constant traffic in the emergency department means that all the air conditioning in the world isn’t gonna keep the temperature bearable. Add to that the plastic gown over several pounds of lead she now wears to shield herself from the portable x-ray’s radiation, and it’s like walking around in a private sauna. A private, _heavy_ sauna. Already her shoulders protest the added weight.

There’s a brief lull while the team sorts itself out. They almost have time to get through a flurry of introductions before a voice from the hallway calls “Incoming!” and they’re off and running.

The gurney’s in view, wheeled by a pair of paramedics whom Carmilla recognizes as regulars: tall, red headed Danny Lawrence and her usual partner Wilson Kirsch, human personification of a golden retriever.

The head of the gurney rolls to a stop just at the level of Carmilla’s navel. As a second year resident, she’s in charge of protecting the airway while her chief Mattie runs the room. There’s the supervising attending lurking in the background, but really it’s the residents’ show.

“Got a 26-year-old female here,” Danny announces. “Tachypneic, tachycardic, BP okay, satting 97% on 12 liters nonrebreather, GCS 15. Burns on both upper and lower extremities, estimate maybe eighteen percent of total body surface area.”

“Okay, let’s go,” Mattie’s voice is profoundly calm, some eye-of-the-storm type voodoo that Carmilla has always envied.

Carmilla automatically places her hands on either side of the patient’s head and looks down for the first time. A pair of big, brown eyes stare right back at her. The rest of patient’s face is obscured by the mask that’s delivering high flow oxygen, but her eyes are enough -- wide and frightened, it’s obvious she’s hurting.

“Ma’am, can you hear me?” Carmilla asks.

 The patient nods.

“Can you speak?”

Again, a nod, and a small “yeah,” that’s slightly muffled by the facemask that’s mostly fogged over with condensation.

“What’s your name?”

This time the patient drags the mask off her face to answer, “Laura.”

“Whoa, whoa, we want to leave that on you, okay? It’s--” Carmilla’s about half way through replacing the mask over her patient’s face when she notices the telltale rings of black around her nose. Her heart turns over in her chest.

“How’s she satting?” She tosses the question over her shoulder. Someone’s already attached the 12-lead to the monitor, and Carmilla can hear the heartbeat jackrabbiting an incessant, high-pitched _beep-beep-beep-beep_.

“90,” is the immediate reply.

“I’m gonna listen to your lungs, okay?” Carmilla says, freeing her stethoscope from around her neck.

There’s definitely an irregular harshness with inspiration. _Stridor,_ Carmilla’s brain supplies automatically. She looks up to see that Mattie, situated just to her left, caught most of this exchange. 

“What do you want to do?” Mattie’s not loud, but her voice cuts through the noise all the same.

“Intubate,” Carmilla answers automatically, already reviewing the procedure in her head. She raises her voice to the assembled team, going for an authoritative tone, “We’ve gotta intubate.”

“Tell her,” Mattie prompts. Takes Carmilla a beat to realize she means the patient.

“Right.” _Shit_. Carmilla clears her throat self-consciously and looks down to -- Lauren? Laura, maybe. She’s pretty sure it’s Laura. God, this is why she prefers unconscious patients. There’s no easy way to tell somebody you’re about to shove a tube down their throat.

“Okay, Laura, we need to help you breathe. We’re going to put a tube in your windpipe to make sure you’re getting enough oxygen.”

Laura’s eyes go wide. “Will it hurt?" 

“We’ll numb you up first. You won’t feel a thing, I promise.” Already someone’s at Carmilla’s elbow, pressing an intubation kit into her hands.

Carmilla’s done this a thousand times. Or, okay, maybe not that many. But her hands know what to do. It’s a calm sort of autopilot, unshakable, even with Laura’s heart going a mile a minute on the monitor.

The anesthetic spray works quickly. Still, Laura convulses involuntarily when Carmilla introduces the curved blade of the laryngoscope. But it’s somewhere outside of Carmilla, a minor irritation. The most that gets through is a passing clinical observation: _gag reflex intact_.

She finds the vocal folds, snakes the tubing between them, pulls the stylet, inflates the balloon cuff. Someone takes over ventilation, and Carmilla bends close with her stethoscope and listens for lung sounds again. This time they _whoosh_ clearly, equally.

“Okay, Laura, okay,” Carmilla murmurs, unhooking the stethoscope from her ears. The noise of the trauma bay breaks over her, but she hardly notices. “We’re done. It’s okay, we’re done. You did so good,” and Laura’s looking up at her like she’s the entire world.

“Ket--” the word sticks in Carmilla’s throat. She clears it and tries again: “Ketamine push.”

The response, “Ketamine in,” comes a moment later.

Laura’s eyelids flutter closed as the sedative pulls her under. A few tears slip from the corners of her closed eyes and slide down her temples, cutting clean tracks in the fine layer of soot coating her face.

Something comes apart in the air between them. A piece of static dissipating.

Carmilla carefully wipes Laura’s tears away, staining the tips of her blue nitrile gloves.


End file.
